Internal bone fixation apparatus



Aug. 28, 1956 R. B. PIERCE 2,760,488

INTERNAL BONE FIXATION APPARATUS Filed April 20, 1955 HFORNEYS INTERNALBONE FIXATION APPARATUS Robert B. Pierce, Olivia, Minn.

Application April 20, 1955, Serial No. 502,608 6 Claims. (Cl. 128-52)This invention relates to apparatus for fixing fragments of a bonetogether in an oblique fracture.

Where a person has suffered an oblique fracture such as in one of thebones in his leg, it is oftentimes desirable to fix the bone fragmentstogether without employing, a plaster cast. In an oblique fracture, thebone fragments must be held together tightly after they have beenreduced so that the bone will heal properly and grow straight. The useof a plaster cast for holding the bone fragments together may retard thehealing of the leg and flesh areas around the fracture because thecirculation of blood may be substantially reduced. Another disadvantagein the use of a plastic cast is the ankylosing effect produced by thecast on the joints adjacent to and on. either side of the fracture site.

An object of my invention is the provision of apparatus of simple andinexpensive construction and operation for fixing together the reducedfragments of a bone in an oblique fracture.

Another object of my invention is to provide a novel apparatus forfixing together the reduced fragments of a bone in an oblique fracturewhich eliminates the need for a plaster cast and which permits the fleshadjacent the bone fracture to heal in a substantially normal manner.

A further object of my invention is the provision of an improvedapparatus for fixing and holding together the reduced bone fragments inan oblique fracture, which apparatus may be left in the leg internallyof the flesh While the bone heals and which apparatus will continuouslyfirmly clamp the bone fragments without permitting the same to loosenduring the healing of the bone.

These and other objects and advantages of my invention will more fullyappear from the following description made in connection with theaccompanying drawings wherein like reference characters refer to thesame or similar parts throughout the several views and in which:

Fig. 1 is an elevation view of the invention;

Fig. 2 is a cross, section view taken on a plane extending substantiallytransversely through the apparatus substantially at- 2-2 of Fig. 1, and

Fig. 3 is a section view taken through a persons leg on a vertical planeshowing several of the devices constituting the invention secured in theleg bone, the several devices being shown at different stages in theirapplication to the leg.

The invention as best shown in Figs. 1 and 2 comprises an elongated andthin wire or rod which is relatively stiff but may be bent by manualmeans and which may be easily severed by a pair of pincers or nippers.At the distal end 11 of wire 10, the wire is sharpened as by swaging.Adjacent to the proximal end 12 of the wire 10 an enlargement orenlarged bead 13 is aflixed to the wire. Bead 13 is smoothly rounded andmay be formed integrally of the wire. Wire 10 has a threaded portion 14medially between the opposite ends thereof and adjacent the enlargedbead 13, and a threaded Patented Aug. 28, 1956 portion 14 of the wireextends toward the distal end 11 from bead 13. The diameter of the wire10 between the threaded portion 14 thereof and the distal end 11 thereofshould be somewhat less than the external diameter of the threadedportion 14 thereof.

An elongated sleeve 15 has an inner end portion 16 which is internallythreaded and of such internal size as to be threadedly secured on thethreaded portion 14 of wire 10. An elongated slot 17 is formed in sleeve15 and extends longitudinally thereof from the inner end portion 16through the outer end portion 18 thereof. Slot 17 is of slightly greaterwidth than the diameter of wire 10 so as to permit the wire to passthrough the slot. The inner end portion 16 of sleeve 15 may be slightlyenlarged and smoothly rounded.

Figure 3 clearly shows the means by which the device is used in fixingthe bone fragments together of a reduced oblique fracture. I have foundby experience that it is desirable to use several of the devices infixing an oblique fracture and in the form shown I have used four suchdevices which may be indicated in general by letters A, B, C and D whichare assembled to show the different stages in the operation of thedevices. Each of the devices in Fig. 3 is identical to that shown inFigs. 1 and 2 and like numerals and characteristics will therefore beused. Device A is shown in the initial stages in the application to theleg. The pointed distal end of the wire will be drilled through the boneand then the wire will be pulled through the bone substantially in thearrangement that device A is shown. with the bead 13 engaging one of thebone fragments. The sleeve 15 of device A has been. slipped over thedistal end of the wire 10 and is partially screwed down toward the bone.

It is good practice when applying the device to the fractured bone tooperate all the devices substantially simultaneously, particularly thedevice adjacent the ends of the oblique fracture. When the devices aresubstantially in the condition of device A as shown traction should beapplied to the distal ends of the devices and particularly the two enddevices, A and D in the form shown, so as to cause the beads 13 of eachof the devices to engage the bone. After the traction has been appliedto the distal end of the device the sleeve 15 will be screwed down ontothe bone substantially into the condition of the device B so as to causethe inner end portion 16 thereof to engage the bone in a positionsubstantially opposite the bead 13 and to cause the bonefragments to betightly clamped together. The wire 10 will then be bent at a positionwithin the sleeve 15 and within the flesh of the leg so as to cause thewire to extend outwardly through the slot 17 of the sleeve 15 and extendsubstantially transversely of the sleeve, to be in the condition ofdevice C as shown. The proximal end 12 of wire 10 will have been severedat a position inwardly of the skin of the leg. As is shown in.

device D, the sleeve 15 will thereafter be severed at a position belowthe skin of the leg and the wire 10' will also be severed and will bebent to be wholly contained below the skin of the leg. Because the wireextends laterally through the sleeve 15, the sleeve cannot rotate withrespect to the wire and therefore cannot loosen itself from the bone.

After all of the devices A, B, C and D have been put into the conditionof device D as shown, the area of the skin through which the deviceshave been inserted will be closed by any suitable means such as byclamps or sutures. The flesh is permitted to heal and the fixationdevices are left in the limb so as to hold the bone at the fracture siteuntil it is completely healed.

After the bone has healed the leg will again be cut open to remove thefixation devices. The sleeve 15 and the wire will be severed at aposition between the bend in the wire and the inner end portion 16 ofthe sleeve. The inner end portion of the sleeve will be unscrewed fromthe wire 10 and the remaining wire and bead 13 will be withdrawn fromthe opposite side of the bone.

It should be noted that the various devices A, B, C and D which are usedto hold the bone fragments at the fracture site may be inserted fromopposite sides of the leg so as to assure proper fixation of the bone.

It will be seen that I have provided new and improved apparatus ofsimple and inexpensive construction for securely fixing bone fragmentstogether in an oblique fracture without the need for a plaster cast andwhich apparatus is relatively easy to apply to the fractured bone and toremove therefrom.

It will, of course, be understood that various changes may be made inthe form, detail, arrangement and proportion of the parts withoutdeparting from the scope of my invention which consists of the matterdescribed herein and set forth in the appended claims.

What is claimed is:

1. A surgical appliance for fixation of fragments of bones in an obliquefracture, comprising an elongated wire having a distal end insertablethrough such fragments at the fracture site and having a proximal end,said wire having an enlargement therein adjacent said proximal end andsaid wire having a threaded portion disposed in proximity with saidenlargement and extending toward said distal end therefrom, aninternally threaded sleeve removably and threadably mounted on said wireand having an outer end extending toward said distal end of said wireand having an inner end extending toward said enlargement, said sleevehaving an elongated slot therein extending longitudinally thereof andinwardly from said outer end thereof, whereby when the wire extendsthrough the bone fragments with said enlargement engaging one side ofthe bone and the inner end of said sleeve engaging the other side of thebone for clamping the same against said enlargement, said wire may bebent within said sleeve to extend outwardly through said slot therein toprevent said sleeve from turning and shifting away from the bone.

2. Apparatus for fixing reduced bone fragments in an oblique fracture,comprising a thin and elongated rod having distal and proximal ends andhaving a threaded portion disposed intermediate of said ends, anenlarged bead fixed to said rod and being disposed between said threadedportion and said proximal end, an elongated sleeve having an internallythreaded inner end portion and having an outer end portion, and saidsleeve also having a slot therein extending longitudinally thereof andthrough said outer end portion, said sleeve being slidable on said rodadjacent the distal end thereof and being threadably mounted on saidthreaded portion of said rod, whereby said sleeve will be removed fromsaid rod to permit said distal end thereof to be inserted through suchbone fragments and said sleeve will be threadably shifted on said rodtoward said bead for clamping the bone fragments therebetween, and saidwire will be bent at a position within said sleeve to extend outwardlythrough said slot thereof.

3. The structure recited in claim 2 and said sleeve having anenlargement at the inner end thereof for engaging the bone and clampingthe same without causing injury thereto.

4. The structure recited in claim 2 and said rod being sharpened at thedistal end thereof to permit the distal end of the rod to be drilledthrough the bone fragments at the fracture site.

5. Apparatus for fixing the bone fragments in an oblique fracture whichhas been reduced, comprising an elongated wire having a proximal end anda distal end and having an enlarged bead thereon for engaging one of thebone fragments through which the distal end of the wire is extended,said wire having a threaded portion disposed in proximity with said headand extending toward said distal end therefrom, an elongated sleevehaving an internally threaded inner end portion and having an outer endportion, said sleeve being threadably mounted on said wire with theinner end portion thereof disposed adjacent said bead and with the outerend portion thereof extending toward said distal end, the inner endportion of said sleeve and said head cooperating to clamp the fracturedand reduced bone fragments therebetween, said sleeve having an elongatedslot extending longitudinally thereof through said outer end portion andinto proximity with said inner end portion, said wire and said sleeveboth being constructed of a severable material, whereby said wire willbe bent at a position within said sleeve to extend outwardly through theslot thereof for restricting shifting of said sleeve longitudinally ofthe wire, and when the bone is healed, said sleeve and wire may both besevered between the inner end portion of said sleeve and the bend in theWire to permit the sleeve to be removed from the wire and thereby permitthe wire to be removed from the bone.

6. Apparatus for fixing reduced bone fragments in an oblique fracture,comprising an elongated wire having a distal end insertable through suchfragments at the fracture site and having a proximal end, said wirehaving an enlarged bead disposed intermediate of said ends and having athreaded portion disposed in proximity with said head and extendingtoward said distal end therefrom, an internally threaded sleeveremovably and threadably mounted on said wire and having an inner endextending toward said bead for engaging the bone and for cooperatingwith said bead in clamping the bone therebetween, whereby said wire maybe severed adjacent said sleeve and adjacent said head to permit theflesh to heal around the fracture as said bone fragments grow backtogether and said wire and sleeve may be removed after the bone hashealed.

References Cited in the file of this patent UNITED STATES PATENTS2,143,922 Longfellow Jan. 17, 1939 FOREIGN PATENTS 1,045,555 France July15, 1953

